A 23 y.o. woman is seen at an outpatient clinic for a routine Pap smear. When questioned, she states she is deciding whether to engage in sexual activity with a man she is just getting to know. She asks how she can tell if he has an STD. Which response by the nurse is best?

Correct Answer: D

Rationale: The best response by the nurse is to recommend an examination by a physician with diagnostic testing as the only way to know if the potential partner is infection free. Simply relying on the appearance of cleanliness or condom use may not be sufficient to determine the presence of sexually transmitted infections (STIs) such as HPV, chlamydia, or herpes, which may not have visible symptoms. Encouraging regular testing and open communication about sexual health with partners is crucial in preventing the spread of STIs.

Correct Answer: C

Rationale: Following a paracentesis procedure where a large amount of ascitic fluid is removed, there is a risk of developing a fluid shift and a potential complication known as "paracentesis-induced circulatory dysfunction" (PICD). This may cause a sudden increase in central blood volume due to rapid re-distribution of fluid, leading to respiratory congestion, dyspnea, and hypoxemia. Therefore, it is crucial for the nurse to monitor the client closely for signs of respiratory distress or congestion immediately after the procedure to prevent any respiratory complications. A rapid, thready pulse (choice A) may indicate hypovolemia, but it is not the most important immediate concern in this case. Decreased peristalsis (choice B) and an increased temperature (choice D) are not typically associated with the immediate post-paracentesis period and are therefore lower priorities compared to monitoring for signs of respiratory congestion.

Correct Answer: C

Rationale: Hypomagnesemia (low magnesium levels) should be checked for in a pregnant client with hypertension and cardiac dysrhythmias because magnesium plays a critical role in maintaining normal cardiac function and blood pressure regulation. It can worsen both hypertension and dysrhythmias if deficient. Hypomagnesemia can lead to cardiac arrhythmias, particularly in the setting of existing cardiovascular conditions. Monitoring and addressing magnesium levels is important in managing these conditions and ensuring maternal and fetal well-being during pregnancy. Checking for hypomagnesemia allows for timely intervention and correction to help prevent any complications.

Correct Answer: B

Rationale: The IV route was likely chosen for the administration of furosemide (Lasix) in this acutely fluid-overloaded patient because IV is the route of choice when rapid administration is needed. When given intravenously, the medication is able to produce a quicker and more immediate diuretic effect compared to oral administration, allowing for more rapid relief of fluid overload symptoms. This can be crucial in emergency situations where the patient's condition requires fast intervention.

Correct Answer: A

Rationale: The presence of white patches on the tonsils is a visual sign that may be revealed by a visual examination in a client with a tonsillar infection caused by group A streptococci. These white patches are known as exudates and can be a characteristic feature of streptococcal tonsillitis. These exudates may range in appearance from small white spots to larger patches that cover the tonsils. Additionally, other signs commonly associated with streptococcal tonsillitis may include swollen and red tonsils, fever, sore throat, and sometimes swollen lymph nodes in the neck. It is important to note that definitive diagnosis often requires laboratory testing such as a rapid strep test or throat culture to confirm the presence of group A streptococci.